Magis Medal Nomination - Alpha Sigma Nu

Nominee

Nominee's Name*

Nominee's Email

Nominee's Address

If unknown, please at least include city, state

Nominee's Address 2

City*

State/Province/Region*

Postal/Zip Code

Country

Nominator's Name*

Nominator's Email*

Nominator's Phone

Relationship

Please describe your relationship to nominee

Nominee Qualifications*

In 500 words or less, please describe the nominee’s qualifications for the Magis Award.

Nominee Bio

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